Threatened miscarriage

Bleeding in early pregnancy is very common. Sometimes the bleeding is an early sign of a miscarriage (loss of the pregnancy) or an ectopic (tubal) pregnancy. In most cases however, the pregnancy will proceed normally.

The bleeding does not indicate that the baby is abnormal or will be harmed if the pregnancy continues.

However, even if the blood loss is quite small and/or you have pain it is important to check that the pregnancy is continuing normally.

If a miscarriage should occur, it is important to realise that couples cannot influence the chance of miscarriage. Much is unknown about miscarriage and a cause can often not be found. Miscarriage occurs in about one in five pregnancies.

Tests

Depending on the stage of your pregnancy different investigations may be required to determine if the pregnancy is proceeding well.

A small blood sample may be taken to determine the level of the pregnancy hormone Beta Human Chorionic Gonadotropin (BHCG) and to identify your blood group and Rhesus factor.

A speculum and vaginal examination will be performed by the doctor. The doctor is looking to determine where the blood is coming from and to find out if the cervix (neck of the womb) is closed or open. The cervix is normally closed. Our staff will try to minimise the discomfort of this necessary examination.

An ultrasound may be arranged for you. At six weeks you should see a fetus in the uterus and possibly a heart beat. Prior to six weeks the fetus is too small to see and the ultrasound may only show the sac for the fetus.

If the bleeding has occurred early in your pregnancy, then the only way to determine what is happening is to do serial blood hormone levels. In early pregnancy the BHCG hormone should approximately double every 48 hours. This is why you may be asked to return for repeat blood tests two days apart.

If you have any questions or concerns, please do not hesitate to ask your midwife or doctor.

What may happen next

You may find that following your bleeding you will have a dark or brownish coloured loss that may continue for a few days.

If at any time your vaginal loss becomes bright and heavy, or you have severe abdominal pain contact your doctor or midwife to get advice.

Pregnancy can be a stressful time, made even worse by bleeding in pregnancy. If you are quite worried we recommend that you contact a social worker or counsellor to talk over any issues or emotional concerns you may be experiencing.